Mimi Dill, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23863 Issued in TN

Practice address

587 Skyline Dr
Jackson, TN 38301-3938

Phone

(731) 424-8922

Fax

(731) 423-2922

NPI assigned

Mar 28, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Extended Care Services PCGroup PAC ID 9133029127, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.15 of 100Reported as group

Quality

74.15

Promoting interoperability

77

Improvement activities

40

Cost

78.84

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mimidill@jcpa.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Extended Care Services PC

  • Physical Medicine & Rehabilitation Physician
  • Englewood, OH
  • NPI 1699522029

  TN

  Medicare reassignment Care Compare group NPD
• West Tennessee Rehab Group, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Jackson, TN
  • NPI 1780675066
  Medicare reassignment NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  NPD (past)
• West Tennessee Medical Group Inc

  • Non-Pharmacy Dispensing Site
  • Ripley, TN
  • NPI 1124748512
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1407351794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP STE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054403",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013938",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Marvin Dr",
            "address_purpose": "LOCATION",
            "city": "Ripley",
            "state": "TN",
            "postal_code": "380637365",
            "country_code": "US",
            "telephone_number": "731-221-3275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3441 Ridgecrest Road Ext # Exd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383057500",
            "country_code": "US",
            "telephone_number": "731-989-9119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 US Highway 70 Byp",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383015074",
            "country_code": "US",
            "telephone_number": "731-421-4826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 W Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013902",
            "country_code": "US",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9159 Telecom Dr",
            "address_purpose": "LOCATION",
            "city": "Milan",
            "state": "TN",
            "postal_code": "383583425",
            "country_code": "US",
            "telephone_number": "731-686-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILL",
        "first_name": "MIMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dickson Medical Equipment, Inc.
• Kelsey Marie Dickson
• Morgan Diebold
• Heather R Dieckmeyer, RN, BSN, MSN
• James J Diffee, MD
• Kevin Brent Dillon, PT
• Tracy L Dillon, P.T.
• Laura L Dipuma, MD
• Felicia Tawah Che Ditah
• Linda Dixon, RDH

• Family Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.